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What are the background checks for health insurance policies?

Typically, waiting periods are different for each disease/disease/treatment and also depend on the specific benefits of the policy. In order to know the exact waiting period applicable to your policy, you must follow the policy wording provided by the health insurer from whom you purchased it.

The waiting period for health insurance is essentially the period during which you cannot take advantage of the benefits of your health insurance policy. It is calculated from the date on which your health policy is first issued.



"Waiting periods shall be maintained as part of the policy to prevent misuse of insurance and to discourage people from filing unethical/fraudulent claims where a person in need of immediate hospitalization has a policy under false pretenses," said Biresh Giri, appointed actuary, ACKO General Insurance.

Typically, waiting periods are different for each disease/disease/treatment and also depend on the specific benefits of the policy. In order to know the exact waiting period' that applies to your policy, you must follow the policy wording provided by the health insurer from whom you purchased the cover.

Health insurance policies usually have an initial waiting period of about a month. What this means is that you cannot use any of your policy benefits for a month starting from the date that your policy was issued. This is only valid for the first time that you purchase a policy and does not apply to policy renewals.


"Any hospitalization claims arising from accidents do not apply to this clause and customers can benefit from the policy benefits," said Parag Ved, Head-Consumer Lines, Tata AIG General Insurance.



To fully understand what 'waiting time for pre-existing diseases' means, you need to understand what insurance companies mean by referring to 'pre-existing diseases (PEDs)' in the policy. The Indian Insurance Regulatory and Development Authority (Irdai) has standardized the definition of PED across health insurance policies. Pre-existing disease refers to any condition, illness, injury, or illness that has been diagnosed up to 48 months prior to the purchase of your health policy. Examples of pre-existing diseases include diabetes, hypertension, thyroid, etc. If you already have a PED, your health insurance is usually not covered immediately. There is a waiting period from the date of the policy issuance after which you can make use of the policy benefits. In order to prevent misuse of health policy, there is usually a list of diseases not covered by the policy for a specific time period (waiting period). The waiting period may vary depending on the particular illness and the benefits of the policy. There is usually a 2-4 year waiting period for these diseases.

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